title: Comparison of lung lesion biopsies between low-dose CT-guided and conventional CT-guided techniques.
abstract: BACKGROUND
  The low-dose computed tomography (CT) technique has been widely used because it decreases the potential risk of radiation exposure, as well as enabling low-dose CT-guided lung lesion biopsy. However, uncertainties remain regarding diagnostic accuracy, radiation dose, complication rate, and image quality.
  
  
  OBJECTIVE
  To compare the diagnostic accuracy, radiation dose, complication rate, and image quality of lung lesion biopsy between conventional CT-guided and low-dose CT-guided techniques.
  
  
  METHODS
  A total of 90 patients were prospectively enrolled and randomized into two groups (group A: 120 kv; 200 mA; thickness, 2.0 mm; pitch, 16 mm/rot; n = 44; group B: 120 kv;10 mA; thickness, 2.0 mm; pitch, 23 mm/rot; n = 46). Sensitivity, specificity, accuracy, positive predictive value (PPV), negative predictive value (NPV), radiation dose, image quality, and complication rate were compared. All variables between the two groups were analyzed using chi-square and Student's t tests. A P value of < 0.05 was considered statistically significant.
  
  
  RESULTS
  The sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) for diagnosing lung lesions were 96.88%, 100%, 97.5%, 100%, and 88.89% in group A, respectively. In group B, the values were 96.67%, 100%, 97.5%, 100%, and 90.91%, respectively (P > 0.05). The mean weighted CT dose index (CTDIw) and dose-length product (DLP) were 29.29 ± 3.93 mGy and 211.74 ± 37.89 mGy*cm in group A and 1.55 ± 0.15 mGy and 10.98 ± 1.56 mGy*cm in group B (P < 0.001). Image quality satisfied the need for a coaxial biopsy. Complications in group A and group B were observed in 27.28% and 23.91% of the patients, respectively (P > 0.05).
  
  
  CONCLUSIONS
  Compared to conventional CT-guided biopsies, lung lesion biopsies guided by the low-dose CT biopsy protocol showed dramatically lower CTDIw and DLP levels. In contrast, the diagnostic yield of the procedures did not differ significantly, which is a recommended technique in certain populations.
authors.affiliation: Department of Radiology, Changzheng Hospital, the Second Military Medical University, Shanghai.
authors.forename: Xiao-xi
authors.initials: XX
authors.lastname: Meng
authors.forename: Xin-ping
authors.initials: XP
authors.lastname: Kuai
authors.forename: Wei-hua
authors.initials: WH
authors.lastname: Dong
authors.forename: Ning-yang
authors.initials: NY
authors.lastname: Jia
authors.forename: Shi-yuan
authors.initials: SY
authors.lastname: Liu
authors.forename: Xiang-sheng
authors.initials: XS
authors.lastname: Xiao
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging / Q000473:pathology; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011829:Radiation Dosage; D015641:Radiography, Interventional / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*; D055815:Young Adult
keywords: Low-dose CT; coaxial biopsy; lung; radiation dose